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22 Oct 2020, Edition - 1927, Thursday

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Health Matters

Can major ortho surgeries be avoided with non-surgical therapies

Indrani Thakurata

With increase in urbanisation and changes brought about due to socio economic reasons, various reports have claimed that our country will see a rise in orthopedic problems in the near future. Perhaps, to some extent, we can blame it on our lifestyle for the rise in orthopaedic injuries. Ofcourse, the population is ageing and the burden on our ortho doctors is more than ever before. “Most of us are complaining of locked ankles, locked knees and various other aches and pains. Spinal problem or shoulder issues are very common with most of us who work on computer for long hours. Even Though ,many of my friends have gone for spinal surgery but one should always avoid surgeries as much as possible with non surgical therapies,” says T. Indrajeeth, a professor who got a spinal surgery done a few years back.

“Broadly orthopedic conditions may be categorized as joint diseases (osteoarthritis etc.), those resulting from trauma, spinal disorders and those associated with autoimmune disorders (ankylosing spondylitis, rheumatoid arthritis etc.) These conditions are progressive and unless addressed at an early stage along with lifelong maintenance measures, lead to functional limitation and decrease in quality of life. Pain and limping gait is a feature common to many orthopedic conditions as is difficulty in climbing stairs or standing for prolonged periods, stiffness and occurrence of physical deformities over time,” says Dr Pradeep Mahajan, Regenerative Medicine Researcher, Adigos Stem Cells. Though a lot of doctors would have you believe that a surgery is the answer for a lot of pain, it is believed that non surgical therapies work wonders where it can. Dr Pradeep elaborates, “ Presently, conventional treatments rely on medications and surgical management, all of which have been known to address the condition existing at a given point in time. Conventional pharmacologic therapies are gradually losing potency owing to reasons such as drug resistance, long duration of treatment, presence of co-existing conditions etc. Ultimately, surgical management such as, core decompression, spine surgery, joint replacement etc. is advised. Surgery may be associated with complications such as infection and requires long healing period. Additionally, implantation of prostheses does not ensure normal joint function and movements in addition to increasing the risk of prosthesis fracture and other complications. Early age of onset of disorders calls for repeated surgical management as the procedures/prosthesis have limited longevity. The need of the hour is newer therapeutic modalities that are definitive, safe and cost effective.”

The alternatives

“Indian medicine has various alternatives. Physiotherapy is one of those alternatives that we at Physio-Be-Fit specialize in. Off-late a lot of individuals prefer non-surgical approaches and elective surgical procedures as an open option. With lack of time and leaves available, jumping to surgery as an option has become more common. Also with a lack of patience in letting an injury heal itself, individuals prefer surgery as a faster healing option. Unlike major trauma or cases needing immediate surgery as an option, non-surgical procedures are now picking up pace as the first line of management by patients,” says Dr Sitaraman Sundaresan, Director and Consultant physiotherapist. Elucidating further, he says, “Knee replacements can be avoided when taken care at an initial stage. Physiotherapy has various options available for it. Similarly with meniscus tears, enough evidence is available which states that compared to 6 months of rehab with no surgery and with surgery end result is the same, in fact better when not operated. Slip discs are and can be avoided for surgical intervention when bed rest and physiotherapy can be combined immediately. Exercises are a must in either cases and are the life line of any condition whether treated surgically or non-surgically. Also, there are cases where alternative medicine works better than surgery in orthopedic front which includes conditions like ankle sprains and ankle injuries. They are the most mistreated joint pains. They are very easy to treat but when stability training is not done post-injury, ankle limping and altered gait is the most affected thing.

What is cell based therapy?

“Cell based therapy has been gaining considerable attention over the years in treatment of acute, chronic, lifestyle related conditions etc. owing to their varied properties. The well known properties of mesenchymal cells are self renewal and multi-differentiation ability. These cells can differentiate into muscle, bone, nerve, cartilage cells thereby ensuring regeneration and not just repair of damaged tissues. These cells are also known as ‘guardians of inflammation’ as they modulate/regulate inflammatory processes in the body. The major advantage of mesenchymal cells is that they are readily available from different sources in the body such as bone marrow, fat tissue, peripheral blood etc. These cells can also be expanded in culture and as they are obtained from the patients’ own body, are safe and generally not tumorigenic. The main goal is to harness the potential of endogenous repair mechanisms to promote healing. Being minimally invasive, there is no need for surgical intervention thereby also reducing recovery period and financial burden. We may soon witness a day when surgical modalities may be completely replaced by advances in regenerative medicine!,” concludes Dr Pradeep.

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